National Assembly for Wales

Well, yes. I just would be interested to know what the timescale for acting on the recommendations is. It all seemed quite sensible—what they were proposing to do—though I'd like to see them taking a bit more of a prescriptive approach, but I just wonder if it would be helpful at some point—whether now or—to ask him for an update, or—. Because it's another one of those where there have been lots of recommendations but it's about when things are going to happen. Not that I want to create more and more work for our—.

No, no. Well, it was quite a forceful report, Members might recall.

I know I wasn't here, but it was—you know, I helped some academics contribute to it in my previous role.

Indeed. So, I think—. Two things: I think most of the timescales we had were six months, and the health Minister is coming back for a spot of scrutiny at some point, isn't he?

So, perhaps we should ask him then.

We're going to request an update on various other things, including this, I think. So, that's the way to hoover things up, I think, and to keep Ministers' feet to the fire, as it were.

I have to say, I'm a bit concerned about this response, because it's very clear that one of the other options was the one that had the majority of support. Now, I do note that, from the consultation, many of the responses were from north Wales. 

Twenty-three out of the 27.

Yes, which is obviously a significant number. But you would expect that because of the nature of traffic, if you like, in the market, as it were, for doctors. So, I'm pretty astonished that the Government seems to have disregarded very much what's been said. In fact, they seem to suggest that the NHS over the border is worse at picking up problems than over here, so we can't be assured that doctors over there are necessarily safe and properly accredited, which—. It just seems to be very odd in terms of a statement, because we could all point to examples over here of where we've had problems as well within our own system. So, I think we should challenge the Government by writing back to say we're not satisfied with the explanation as to why they're pursuing the option they're pursuing, and we do feel that there needs to be better regard paid to the outcome of the consultation. 

That's fair. I had some disquiet myself when we—. Because it wasn't clear, out of the seven options, to me, which option they were going to follow, because, as you say, option 3 was the one that most people favoured, but then they discounted that option because of subsequent evidence from England, and that discounted option 4 as well. So, can we write back seeking some further clarification, I think, on what is going on as regards the all-Wales performers list?

I think it's a little bit more than that though, isn't it? Because I think they're overemphasising this issue of safety. If you look at the scale of NHS England versus scale of NHS Wales, you're bound to have more frequent problems in a much larger pool of staff. Proportionally, I don't think it's any worse or better than the situation here.

Yes, well, we'll get them to explain themselves, I think, as part of the letter. Okay.

Can I go back to 2.5, please?

Yes, whichever one that was.

It's the nurse staffing levels.

The nurse staffing levels, right.

I've read through the response from the Minister and I noticed that he focuses on—rightly so, to an extent—the compliance with the Act. What my concern is is there's no reference to what the implications are for other wards, which are not required under the Act. Because I've heard from staff in various locations that there are challenges in those wards as a consequence of staff needing to be on particular wards, and therefore I think we should ask whether they have done any analysis as to the implications for other wards when they're doing this assessment on compliance.

Unintended consequences.

We raised those unintended consequences when the Bill came through.

Yes, I know—lots of times, to such a degree that it's probably an intended consequence, then, but anyway.

So, I think it is—. It's not in here. I think we should reflect upon whether they have done any analysis as to whether the unintended consequences have come to light.

Yes, I think that's very pertinent. And what's also pertinent is that next week we start our review into community and district nursing, so nursing will be on our agenda for the next few weeks. So, that sort of train of thought will—. But we will make that specific point in response to that.